影响腹腔镜左肝外叶切除术后不良预后的发生因素分析及治疗建议

Analysis of factors affecting poor prognosis after laparoscopic left lateral liver resection and the treatment recommendations

目的分析腹腔镜左肝外叶切除术后不良预后的发生因素,并提出治疗建议。方法对240例腹腔镜左肝外叶切除术患者的资料进行回顾,分析不良预后的影响因素,并提出治疗建议。结果患者预后不良发生率为12.92%。单因素分析显示,预后不良组年龄>60岁、恶性肿瘤、术前Child分级III～IV级、贫血和低蛋白血症者构成比均高于预后良好组(P<0.05),Logistic分析显示上述因素均为独立危险因素(P<0.05)。单因素分析显示,预后不良组术后持续氧气吸入构成比低于预后良好组(P<0.05),经Logistic分析显示其为保护因素(P<0.05)。结论腹腔镜左肝外叶切除术后不良预后的发生率高,年龄>60岁、恶性肿瘤等均是其危险因素,术后持续氧气吸入治疗是其保护因素,建议对患者进行针对性治疗。

Objective To analyze the factors of poor prognosis after laparoscopic left lateral liver resection, and to providetreatment recommendations. Methods The data of 240 cases treated with laparoscopic left lateral liver resection werereviewed, and the factors affecting poor prognosis were analyzed, and the suggestions for treatment were put forward. ResultsThe incidence of poor prognosis was 12.92%. The univariate analysis revealed that the ratios of age〉60, malignant tumors,preoperative Child Ⅲ-Ⅳ grades, anemia and hypoproteinemia in the poor prognosis group were higher than those in the goodprognosis group （P〈0.05）, which were the independent risk factors by Logistic analysis（P〈0.05）. The univariate analysisrevealed that the ratio of continuous oxygen inhalation in the poor prognosis group was lower than that in the good prognosisgroup （P〈0.05）, which was a protective factor by Logistic analysis （P〈0.05）. Conclusion After laparoscopic left extrahepaticlobectomy, the incidence of poor prognosis is high. Age〉60 and malignant tumor are all its risk factors. Continuous oxygeninhalation after operation is a protective factor. It is suggested to carry out targeted treatment for patients.